Mustamsir Edi, Aji Aulia Pandu, Adiwangsa Ahmad Abdilla, Akmalizzan Azfar Ahnaf
Orthopaedics and Traumatology Department, Faculty of Medicine, Brawijaya University - Saiful Anwar General Hospital, Malang 65142, East Java, Indonesia.
General Practitioner, Malang 65142, East Java, Indonesia.
SICOT J. 2025;11:6. doi: 10.1051/sicotj/2024061. Epub 2025 Jan 23.
Knee joint stability is influenced by force distribution and ligament structures. High Tibial Osteotomy (HTO) treats knee deformities and redistributes load, reducing further invasive procedures. High Tibial Osteotomy (HTO) is a well-established procedure for addressing knee instability, particularly in cases involving ligament deficiencies such as ACL and PCL insufficiencies. This systematic review aims to evaluate the clinical outcomes and long-term efficacy of HTO in improving knee stability and function.
A systematic literature search was conducted using Cochrane Central, PubMed, MEDLINE, and ProQuest databases for studies published between 2000 and June 2024. Eligible studies included human subjects with at least six months of follow-up and focused on HTO for knee instability. Exclusion criteria included animal studies, non-knee joint studies, and reviews. Data on patient demographics, follow-up duration, subjective and objective outcomes, and complications were extracted.
Out of 536 studies identified, 11 met the inclusion criteria, encompassing 303 patients. Combining HTO with ACL or PCL reconstruction significantly improved both subjective instability and objective measures, including Lachman and Pivot Shift test grades. Patient satisfaction was high, and functional scores such as Lysholm and Tegner improved markedly. The incidence of complications was low, with minor issues such as infections and delayed union, and no reported graft failures.
HTO, particularly when combined with ligament reconstruction, effectively treats knee instability due to ACL or PCL deficiency. The procedure demonstrates strong mid- to long-term outcomes, high patient satisfaction, and a low rate of complications. It remains a viable option for patients with knee instability.
膝关节稳定性受力量分布和韧带结构影响。高位胫骨截骨术（HTO）用于治疗膝关节畸形并重新分配负荷，减少进一步的侵入性手术。高位胫骨截骨术（HTO）是一种成熟的治疗膝关节不稳定的手术，尤其适用于涉及韧带缺陷（如前交叉韧带和后交叉韧带功能不全）的病例。本系统评价旨在评估高位胫骨截骨术在改善膝关节稳定性和功能方面的临床疗效和长期效果。
使用Cochrane Central、PubMed、MEDLINE和ProQuest数据库对2000年至2024年6月发表的研究进行系统文献检索。符合条件的研究包括随访至少6个月的人类受试者，并聚焦于治疗膝关节不稳定的高位胫骨截骨术。排除标准包括动物研究、非膝关节研究和综述。提取了患者人口统计学数据、随访时间、主观和客观结果以及并发症的数据。
在识别出的536项研究中，11项符合纳入标准，涵盖303名患者。将高位胫骨截骨术与前交叉韧带或后交叉韧带重建相结合，显著改善了主观不稳定和客观指标，包括Lachman试验和轴移试验分级。患者满意度较高，Lysholm和Tegner等功能评分显著改善。并发症发生率较低，存在感染和延迟愈合等小问题，未报告移植物失败情况。
高位胫骨截骨术，尤其是与韧带重建相结合时，能有效治疗因前交叉韧带或后交叉韧带缺陷导致的膝关节不稳定。该手术显示出良好的中长期效果、较高的患者满意度和较低的并发症发生率。对于膝关节不稳定患者而言，它仍是一个可行的选择。
